﻿<table>
    <thead>
        <tr>
            <th>Laboratorio: </th>
            <th>Equipamento: </th>
            <th>Defeito: </th>
            <th>Data: __/__/____</th>
            <th>Requisitante: </th>
        </tr>
        <tr>
            <th>Data: __/__/____</th>
            <th>Providencia</th>
            <th>Respons�vel</th>
        </tr>
    </thead>
    <tbody>
        <tr>
            <td></td>
            <td></td>
            <td></td>
        </tr>
    </tbody>
</table>